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On the horizon

On the horizon

Can a device replace warfarin? In a heart beset by atrial
fibrillation, blood clots can develop in the heart's upper
chambers (the atria). Most of them form in the left atrial
appendage, a thumblike pocket in the left atrium. Closing off
this pocket with surgery or a fabric-covered cage could offer an
alternative to the blood thinner warfarin (Coumadin, Jantoven,
generic). Small trials suggest that these approaches can keep
stroke-causing clots from entering the circulation, but questions
about how well they stack up against warfarin for safety and
effectiveness must be answered by ongoing trials.

Lasers for stroke. Sending laser beams into the brain
could someday help lessen the impact of a stroke. The most
effective treatment for stroke today, a clot-busting drug called
tissue plasminogen activator, must be given within three hours of
the start of a stroke. Researchers are testing transcranial laser
therapy as late as 24 hours after a stroke has begun. Here's how
it works: after having his or her hair shaved off, a stroke
victim is fitted with a special cap that directs laser beams into
the brain. The light waves are thought to rev up the metabolism
of oxygen-deprived brain cells and keep them alive until the
blockage causing the stroke shrinks or disappears. The results of
early trials are mixed.

Disappearing heart stents. Wire-mesh stents are routinely
used to prop open a narrowed or blocked coronary artery after it
has been opened by balloon angioplasty. The earliest stents, made
of bare metal, often triggered a wild regrowth of cells lining
the artery, causing it to narrow again. Stents now in use carry
medication that is released slowly, which prevents this
overgrowth. The drawback is that blood clots sometimes form on
these drug-eluting stents, necessitating the long-term use of
aspirin and clopidogrel (Plavix). Researchers are working on the
next generation — a stent that stabilizes and reshapes the
artery, then slowly dissolves. Two-year results from an ongoing
trial give good grades to a bioabsorbable stent. Although no such
stent is yet on the market, the promising results will probably
spur stent makers to begin seeking FDA approval.

Best-selling Reports

Harvard Health Minute

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Daily Health Tip

Ease into exercise

No pill can possibly give you the same benefits as regular exercise. And your exercise doesn't have to be daunting. If exercise isn't part of your day, start out with a 5-minute walk each day. Then ease into longer strolls. If walking is painful, try swimming or cycling.